Blood pressure has long been one of the best markers of your health. It is a number you can remember and monitor. High blood pressure (hypertension) is linked to a greater risk of heart attacks and strokes.

About one out of three adults has high blood pressure, which is usually defined as a reading of 140/90 millimeters of mercury (mm Hg) or higher.

The first, or upper, number (systolic pressure) represents the pressure inside the arteries when the heart beats, and the second, or lower, number (diastolic pressure) is the pressure between beats when the heart rests.

Blood pressure rises with age because of increasing stiffness of large arteries, long-term buildup of plaque, and the effects of other diseases involving the heart and blood vessels. Typically, more attention is given to the diastolic reading as a major risk factor for cardiovascular disease.

“In fact, for a long time, some physicians felt that a systolic (upper) number higher than 140 could be tolerated in older people,” says Dr. Paul Huang, a cardiologist with Harvard-affiliated Massachusetts General Hospital. “But both upper and lower numbers are equally important.”

While 140/90 continues to be the blood pressure cutoff, a study published in the Nov. 26, 2015 issue of The New England Journal of Medicine shows that lowering pressure to around 120/80 may reap greater benefits.

Researchers examined the initial results from the Systolic Blood Pressure Intervention Trial, or SPRINT, which studied 9,361 adults over age 50 who either had hypertension or were at a high risk for cardiovascular disease.

The subjects were divided into two groups. The first received an intensive treatment to lower blood pressure to less than 120/80. The other group followed a standard treatment to lower it to less than 140/90.

After three years, the researchers found that the group with the target of below 120/80 had a 25% lower risk of heart attack, stroke, or cardiovascular death compared with those with the standard target of less than 140/90. They also had 27% fewer deaths from any cause. (The study was stopped early because the outcome in the intensive treatment group was so much better than in the standard treatment group.)Ups and downs of lower numbers

This study supports observational studies that have found that lower blood pressure reduces cardiovascular risk.

But what does it take to get to the lower numbers? “On average, the people in the intensive treatment group took three blood pressure medications, while those in the standard treatment group only took two,” says Dr. Huang.

Moreover, the study found that the benefits in reducing heart attacks, strokes, and death were found equally in those older or younger than age 75. “So we can no longer say that a higher blood pressure is okay just because someone’s older,” he says.

But should older men focus on going lower? Is lower than 140/90 good enough, or should you be more aggressive and get that number down as close as possible to 120/80?

“If you currently are on blood pressure medicine, and your pressure is lower than 140/90, you should discuss with your doctor whether you should aim to go even lower,” says Dr. Huang. “There may be additional benefits to further reducing your stroke and heart attack risk.”

Still, there may be some downsides to going lower. For instance, many people may not want to take any additional medication. They may be concerned about battling common side effects, such as extra urination, erection problems, weakness, dizziness, insomnia, constipation, and fatigue. They also may have enough trouble monitoring their current medication without adding more to the mix.

Another potential problem: pressure that drops too low. “This could lead to dizziness and lightheadedness, especially when suddenly rising from a seated position, and increase your risk of falls,” says Dr. Huang.

Also, because the study was stopped early, other possible downsides of the extra medications, such as effects on cognitive function or kidney function, remain unknown.

If anything, this study reinforces the need for men to be more diligent about maintaining a healthy level, says Dr. Huang. He suggests older men follow these basic guidelines:

*Check your pressure every month and alert your doctor to changes. “If the upper number is repeatedly higher than 140, or the lower number higher than 90, let your doctor know,” he says.

*Continue to take your medications as prescribed. “If you suffer from any side effects, talk with your doctor about changing the dosage or drug.”

*Reduce your salt intake. “You do not have to go sodium-free, but be more aware of how much sodium is in the foods you eat,” he says. In general, try to keep your sodium intake below 2,000 milligrams a day. Foods that include the words “smoked,” “processed,” “instant,” or “cured” in the name or on the label are often quite high in sodium.

*Continue to exercise or adopt some kind of workout routine. “Activity and weight loss can help lower and maintain a healthy blood pressure,” says Dr. Huang.

Definition:Psoriatic arthritis is a form of arthritis that affects some people who have psoriasis— a condition that features red patches of skin topped with silvery scales. Most people develop psoriasis first and are later diagnosed with psoriatic arthritis, but the joint problems can sometimes begin before skin lesions appear.

Joint pain,stiffness and swelling are the main symptoms of psoriatic arthritis. They can affect any part of your body, including your fingertips and spine, and can range from relatively mild to severe. In both psoriasis and psoriatic arthritis, disease flares may alternate with periods of remission.

It is a type of inflammatory arthritis that will develop in up to 30 percent of people who have the chronic skin condition psoriasis. Psoriatic arthritis is classified as a seronegative spondyloarthropathy and therefore occurs more commonly in patients with tissue type HLA-B27.

No cure for psoriatic arthritis exists, so the focus is on controlling symptoms and preventing damage to the joints. Without treatment, psoriatic arthritis may be disabling.

Classification:There are five main types of psoriatic arthritis:

*Asymmetric: This type affects around 70% of patients and is generally mild. This type does not occur in the same joints on both sides of the body and usually only involves fewer than 3 joints.

*Symmetric:This type accounts for around 25% of cases, and affects joints on both sides of the body simultaneously. This type is most similar to rheumatoid arthritis and is disabling in around 50% of all cases.

*Arthritis mutilans (M07.1): Affects less than 5% of patients and is a severe, deforming and destructive arthritis. This condition can progress over months or years causing severe joint damage. Arthritis mutilans has also been called chronic absorptive arthritis, and may be seen in rheumatoid arthritis as well.

*Spondylitis (M07.2): This type is characterised by stiffness of the spine or neck, but can also affect the hands and feet, in a similar fashion to symmetric arthritis.

*Distal interphalangeal predominant (M07.0): This type of psoriatic arthritis is found in about 5% of patients, and is characterised by inflammation and stiffness in the joints nearest to the ends of the fingers and toes. Nail changes are often marked.

Symptoms:
*Pain, swelling, or stiffness in one or more joints is commonly present.

*Pain in and around the feet and ankles, especially tendinitis in the Achilles tendon or plantar fasciitis in the sole of the foot.

*Changes to the nails, such as pitting or separation from the nail bed.

*Pain in the area of the sacrum (the lower back, above the tailbone).

*Along with the above noted pain and inflammation, there is extreme exhaustion that does not go away with adequate rest. The exhaustion may last for days or weeks without abatement. Psoriatic arthritis may remain mild, or may progress to more destructive joint disease. Periods of active disease, or flares, will typically alternate with periods of remission. In severe forms, psoriatic arthritis may progress to arthritis mutilans which on X-ray gives pencil in cup appearance.

*Because prolonged inflammation can lead to joint damage, early diagnosis and treatment to slow or prevent joint damage is recommended.

*Scaly skin lesions are seen over extensor surfaces (scalp, natal cleft and umbilicus).

Causes:
Psoriatic arthritis occurs when the body’s immune system begins to attack healthy cells and tissue. The abnormal immune response causes inflammation in your joints as well as overproduction of skin cells.

It’s not entirely clear why the immune system turns on healthy tissue, but it seems likely that both genetic and environmental factors play a role. Many people with psoriatic arthritis have a family history of either psoriasis or psoriatic arthritis. Researchers have discovered certain genetic markers that appear to be associated with psoriatic arthritis.

Physical trauma or something in the environment — such as a viral or bacterial infection — may trigger psoriatic arthritis in people with an inherited tendency.

Diagnosis:
There is no definitive test to diagnose psoriatic arthritis. Symptoms of psoriatic arthritis may closely resemble other diseases, including rheumatoid arthritis. A rheumatologist (a doctor specializing in diseases affecting the joints) may use physical examinations, health history, blood tests and x-rays to accurately diagnose psoriatic arthritis.

Factors that contribute to a diagnosis of psoriatic arthritis include:

*Psoriasis in the patient, or a family history of psoriasis or psoriatic arthritis.

*Ridging or pitting of fingernails or toenails (onycholysis), which is associated with psoriasis and psoriatic arthritis.

*Radiologic images indicating joint change.

*Other symptoms that are more typical of psoriatic arthritis than other forms of arthritis include inflammation in the Achilles tendon (at the back of the heel) or the Plantar fascia (bottom of the feet), and dactylitis (sausage-like swelling of the fingers or toes)

During the exam,the doctor may ask for the following tests:

Imaging tests:

*X-rays. Plain X-rays can help pinpoint changes in the joints that occur in psoriatic arthritis but not in other arthritic conditions.Magnetic resonance imaging (MRI). MRI utilizes radio waves and a strong magnetic field to produce very detailed images of both hard and soft tissues in your body. This type of imaging test may be used to check for problems with the tendons and ligaments in your feet and lower back.Laboratory tests:

*Rheumatoid factor (RF). RF is an antibody that’s often present in the blood of people with rheumatoid arthritis, but it’s not usually in the blood of people with psoriatic arthritis. For that reason, this test can help your doctor distinguish between the two conditions.

*Joint fluid test. Using a long needle, your doctor can remove a small sample of fluid from one of your affected joints — often the knee. Uric acid crystals in your joint fluid may indicate that you have gout rather than psoriatic arthritis.

Treatments:
The underlying process in psoriatic arthritis is inflammation; therefore, treatments are directed at reducing and controlling inflammation. Milder cases of psoriatic arthitis may be treated with NSAIDS alone; however, there is a trend toward earlier use of disease-modifying antirheumatic drugs or biological response modifiers to prevent irreversible joint destruction.

Nonsteroidal anti-inflammatory drugs:
Typically the medications first prescribed for psoriatic arthritis are NSAIDs such as ibuprofen and naproxen followed by more potent NSAIDs like diclofenac, indomethacin, and etodolac. NSAIDs can irritate the stomach and intestine, and long-term use can lead to gastrointestinal bleeding. Other potential adverse effects include damage to the kidneys and cardiovascular system.

Disease-modifying antirheumatic drugs:
These are used in persistent symptomatic cases without exacerbation. Rather than just reducing pain and inflammation, this class of drugs helps limit the amount of joint damage that occurs in psoriatic arthritis. Most DMARDs act slowly and may take weeks or even months to take full effect. Drugs such as methotrexate or leflunomide are commonly prescribed; other DMARDS used to treat psoriatic arthritis include cyclosporin, azathioprine, and sulfasalazine. These immunosuppressant drugs can also reduce psoriasis skin symptoms but can lead to liver and kidney problems and an increased risk of serious infection.

Biological response modifiers:
Recently, a new class of therapeutics called biological response modifiers or biologics has been developed using recombinant DNA technology. Biologic medications are derived from living cells cultured in a laboratory. Unlike traditional DMARDS that affect the entire immune system, biologics target specific parts of the immune system. They are given by injection or intravenous (IV) infusion.

Biologics prescribed for psoriatic arthritis are TNF-(alfa) inhibitors, including infliximab, etanercept, golimumab, certolizumab pegol and adalimumab, as well as the IL-12/IL-23 inhibitor ustekinumab.

Biologics may increase the risk of minor and serious infections. More rarely, they may be associated with nervous system disorders, blood disorders or certain types of cancer.

Other treatments:
Retinoid etretinate 30mg/day is effective for both arthritis and skin lesions. Photochemotherapy with methoxy psoralen and long wave ultraviolet light (PUVA) are used for severe skin lesions. Doctors may use joint injections with corticosteroids in cases where one joint is severely affected. In psoriatic arthritis patients with severe joint damage orthopedic surgery may be implemented to correct joint destruction, usually with use of a joint replacement. Surgery is effective for pain alleviation, correcting joint disfigurement, and reinforcing joint usefulness and strength.

Prognosis:
Seventy percent of people who develop psoriatic arthritis first show signs of psoriasis on the skin, 15 percent develop skin psoriasis and arthritis at the same time, and 15 percent develop skin psoriasis following the onset of psoriatic arthritis.

Psoriatic arthritis can develop in people who have any level severity of psoriatic skin disease from mild to very severe.

Psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. For the majority of people this is between the ages of 30 and 55, but the disease can also affect children. The onset of psoriatic arthritis symptoms before symptoms of skin psoriasis is more common in children than adults.

More than 80% of patients with psoriatic arthritis will have psoriatic nail lesions characterized by nail pitting, separation of the nail from the underlying nail bed, ridging and cracking, or more extremely, loss of the nail itself (onycholysis).

Men and women are equally affected by this condition. Like psoriasis, psoriatic arthritis is more common among Caucasians than Africans or Asians

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Other Names: Broken-heart syndrome, Transient apical ballooning syndrome, Apical ballooning cardiomyopathy,Stress-induced cardiomyopathy, Gebrochenes-Herz-Syndrom, and Stress cardiomyopathy.Definition:
Takotsubo cardiomyopathy is a type of non-ischaemic cardiomyopathy in which there is a sudden temporary weakening of the myocardium. Because this weakening can be triggered by emotional stress, It occurs as the response of the heart to sudden, intense emotional stress such as the death of a spouse; rejection at the workplace; acute fear; or uncontrolled anger. These intense emotions can cause immediate breathlessness or strokes. The broken heart can occur simultaneously or a few minutes later. Stress cardiomyopathy is a well-recognized cause of acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.

Around ten years ago, there were a few high profile deaths in young people. They were diagnosed as having died from a “broken heart”. Now, a broken heart or stunned myocardium syndrome is a documented condition.Symptoms:
Takotsubo cardiomyopathy or Broken heart syndrome symptoms can mimic a heart attack.The symptoms are similar to a heart attack – chest pain, sweating, giddiness or dizziness, nausea, vomiting, weakness and palpitations. Blood pressure may drop. Heart failure may develop.

Any long-lasting or persistent chest pain could be a sign of a heart attack, so it’s important to take it seriously and call your doctor if you experience chest pain.

Causes:
The exact cause of Takotsubo cardiomyopathy is not very clear. It is thought that a surge of stress hormones, such as adrenaline, might temporarily damage the hearts of some people. How these hormones might hurt the heart or whether something else is responsible isn’t completely clear. A temporary constriction of the large or small arteries of the heart may play a role.

Takotsubo cardiomyopathy is often preceded by an intense physical or emotional event. Some potential triggers are:

*News of an unexpected death of a loved one
*A frightening medical diagnosis
*Domestic abuse
*Losing a lot of money
*Natural disasters
*A surprise party
*Having to perform publicly
*Job loss
*Divorce
*Physical stressors, such as an asthma attack, a car accident or major surgery

It’s also possible that some drugs, rarely, may cause broken heart syndrome by causing a surge of stress hormones. Drugs that may contribute to broken heart syndrome include:

*Epinephrine (EpiPen, EpiPen Jr), which is used to treat severe allergic reactions or a severe asthma attack
*Duloxetine (Cymbalta), a medication given to treat nerve problems in people with diabetes, or as a treatment for depression
*Venlafaxine (Effexor XR), which is a treatment for depression
*Levothyroxine (Synthroid, Levoxyl), a drug given to people whose thyroid glands don’t work properlyDifferances between Takotsubo cardiomyopathy and hear attack are:

Heart attacks are generally caused by a complete or near complete blockage of a heart artery. This blockage is due to a blood clot forming at the site of narrowing from fatty buildup (atherosclerosis) in the wall of the artery. In Takotsubo cardiomyopathy, the heart arteries are not blocked, although blood flow in the arteries of the heart may be reduced.Diagnosis:
Takotsubo cardiomyopathy or Transient apical ballooning syndrome is found in 1.7–2.2% of patients presenting with acute coronary syndrome. While the original case studies reported on individuals in Japan, Takotsubo cardiomyopathy has been noted more recently in the United States and Western Europe. It is likely that the syndrome went previously undiagnosed before it was described in detail in the Japanese literature.

The diagnosis of Takotsubo cardiomyopathy may be difficult upon presentation. The ECG findings are often confused with those found during an acute anterior wall myocardial infarction. It classically mimics ST-segment elevation myocardial infarction, and is characterised by acute onset of transient ventricular apical wall motion abnormalities (ballooning) accompanied by chest pain, dyspnea, ST-segment elevation, T-wave inversion or QT-interval prolongation on ECG. Elevation of myocardial enzymes is moderate at worst and there is absence of significant coronary artery disease.

The diagnosis is made by the pathognomonic wall motion abnormalities, in which the base of the left ventricle is contracting normally or is hyperkinetic while the remainder of the left ventricle is akinetic or dyskinetic. This is accompanied by the lack of significant coronary artery disease that would explain the wall motion abnormalities. Although apical ballooning has been classically described as the angiographic manifestation of takotsubo, it has been shown that left ventricular dysfunction in this syndrome includes not only the classic apical ballooning, but also different angiographic morphologies such as mid-ventricular ballooning and rarely local ballooning of other segments.

The ballooning patterns were classified by Shimizu et al. as takotsubo type for apical akinesia and basal hyperkinesia, reverse takotsubo for basal akinesia and apical hyperkinesia, mid-ventricular type for mid-ventricular ballooning accompanied by basal and apical hyperkinesia and localised type for any other segmental left ventricular ballooning with clinical characteristics of takotsubo-like left ventricular dysfunction.

The ECG changes are atypical, with imprecise changes in the ST segment and T waves. They are “suspicious of but non conclusive” of myocardial infraction. Blood tests for the enzyme creatine kinase and proteins troponin should be done. These are elevated in a heart attack. In a stunned heart, these results too are inconclusive. The echocardiogram is the clincher. The heart is ballooned out. This change occurs typically at the apex of the heart. It is important to make a distinction between heart attack and takotsubo as the medication is different.

Treatment:
The treatment for takotsubo is mainly supportive. Medication is given to remove fluid from the lungs and prevent clots. Recovery occurs within a few days.

About two per cent of people who were thought to have a heart attack actually had broken hearts. In the case of women, this increases to seven per cent. Women, mainly menopausal ones (60-75 years), have “broken hearts” eight to nine times more often than men. Some people are genetically prone to “broken hearts.” Depression plays a role in susceptibility to this condition. Recurrences can occur in 10 per cent of people.

People who are in poor physical condition do not need severe emotional stress to suffer a broken heart. An episode may be precipitated by a minor event like rejection, or even a lecture or talk before an audience.

In order to never develop this condition; it is important to develop metal and physical toughness. Walking for 40-60 minutes a day at a brisk pace exposes the heart to small doses of adrenaline and nor adrenaline in a controlled manner. The heart gets conditioned and is immune to sudden chemical surges. Meditation and yoga provide calmness and the mental strength to cope with good days and bad.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Description:
Hawthorn is a small to midium sized deciduous tree 5 to 15mtr. tall, grows as a hedge plant in Europe but found mostly in temperate regions North America ,Western Asia, India, China and northern Africa.Its flowers are umbrella shaped and clustered white or pink,leaves are glossy green toothed and the berries are bright shiny red. The white coloured flowers are borne in flat-topped inflorescences termed corymbs or globular in inflorescences termed umbels and usually contains 5 petals,5 and 18 stamens and have a rancid oder. the fruits are known as pomes, although the seeds and their bony ndocarps are termed pyrenes. The calyx is present. The throns are small with sharp tipped branches that arise either from other branches or from the trunk, and are typically 1-3 cm long.Hawthorn bark or stem has hardwood ,smooth and ash-grey.CLICK & SEE THE PICTURES..>….(01).......(1).…..(2).

*anti-arrhythmic effects (heart)
*anticoagulant [an agent that prevents the formation of clots in a liquid, as in blood]
*antispasmodic [an agent that relieves or checks spasms or cramps]
*antioxidants [contributing to the oxidation of free radicals which are believed to contribute to premature aging and dementia] that help increase the flow of blood and oxygen to the heart

*helps rid the body of excess salt and water thus supporting weight-loss and weight control programs
*urinary tract infections, combined with Agrimony, Thyme and Golden Rod

Respiratory Tract Conditions

*sore throat

Other Uses:

*an excellent liquor made from Hawthorn berries and brandy
*repels bees and is only pollinated by flies

Hawthorn is best-used long term as the active constituents do not produce rapid results. Benefits develop slowly having a direct effect on the heart itself, especially in cases of heart damage and heart problems associated with liver disease. It is gentle and safe for long-term use with no toxic side effects.

Disclaimer:
The information presented herein is intended for educational purposes only. Individual results may vary, and before using any supplements, it is always advisable to consult with your own health care provider.